Customer Service Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Develop and uphold a comprehensive understanding of the current products and services offered by the company.

• Respond to inbound calls and emails while also making outbound calls in a prompt manner.

• Document call details in accordance with standard operating procedures.

• Provide answers to inquiries regarding products, services, retail locations, general service line details, and other customer requirements.

• Process orders, direct calls, and follow up on customer inquiries.

• Review documentation to ensure accuracy.

• Process, verify, and/or submit necessary documentation and orders.

• Complete insurance verifications for eligibility, coverage, co-insurances, and deductibles.

• Obtain pre-authorizations when necessary and process physician orders to insurance providers.

• Navigate various online EMR systems to retrieve documentation.

• Enter and review relevant information in the EMR system, including authorizations and expiration dates.

• Communicate with Customer Service and Management regarding trends with insurance companies.

• Verify insurance carriers listed in the company database and request additions as needed.

• Contact patients when documentation fails to meet payer guidelines, providing updates or alternatives.

• Meet quality assurance standards and key performance indicators.

• Address and resolve customer complaints and issues.

• Educate patients about their financial responsibilities when applicable.

• Utilize company-provided resources, including Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI, PECOS, and How-To documents.

⛳️ Requirements

• High School Diploma or equivalent.

• One (1) year of relevant experience in healthcare administration, finance, or insurance customer service, claims, billing, call center work, or management across any industry.

• For senior level positions, two (2) years of relevant experience and one (1) year of direct job experience is required.

• Proficient computer skills and familiarity with Microsoft Office.

• General understanding of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements is preferred.

• Capability to navigate multiple online EMR systems.

• Exceptional customer service abilities.

• Strong analytical and problem-solving skills with a keen attention to detail.

• Excellent verbal and written communication skills.

• Ability to prioritize and manage several tasks simultaneously.

• Willingness to learn new technologies and comprehend data flow through systems and their interactions.

• Ability to work independently as well as collaboratively in a team environment.

• Adaptability and flexibility in a fast-paced, changing environment.

🏝️ Benefits

• AdaptHealth is an equal opportunity employer.